Health behaviours and cardiovascular risk in Ethiopian adolescent immigrants
Uri Bronfenbrenner's bioecological model holds that human development is influenced by processes, person, context and time. The project BYAIMS (Native-born youth of African immigrants and cardiovascular risk: A mixed methods study) examined the influence of the model's four domains on CR factors in adolescents. The particular focus was on first- and second-generation adolescents of Ethiopian descent. Europe and Israel, common destinations for migrants from Africa's least developed nations, are home to some 600 000 and 120 000 Ethiopian immigrants, respectively. BYAIMS researchers conducted community-based participatory research to compare samples of these populations to other immigrants and non-immigrants. The findings showed that all adolescent immigrants reported lower socioeconomic status, higher levels of psychological symptoms and more frequent school difficulties. However, compared to other immigrants and non-immigrants, second-generation Ethiopian adolescent male immigrants demonstrated the poorest health status (CR factors). While other adolescent immigrants and non-immigrants sought health information mainly from parents, Ethiopian immigrants primarily used the Internet for such input. They also reported comparatively poorer health treatment and less positive communication with doctors. All groups dealt with stressors related to peers, schooling, and helping parents with culture and language. However, BYAIMS showed that Ethiopian adolescent immigrants have additional stress related to pervasive racist attitudes, discrimination and disrespect in their host societies. More work is needed on interventions designed to acculturate immigrant adolescents from poor families. Although some have been successful in influencing CR factors such as diet and exercise, they have fallen short in others, such as smoking. At the same time, while these interventions have facilitated acclimation to Israeli culture, they have also resulted in the loss of Ethiopian immigrant culture. BYAIMS research has shown that all bioecological domains (family, school, health system, societal attitudes and governmental policies) influence CR factors. Importantly, these are often more pronounced for Ethiopian adolescent immigrants. Many attitudes and behaviours become established during adolescence, and thus disadvantages experienced during this critical developmental stage threaten to impact an individual's life course. The study's findings can be used to develop more effective healthcare interventions for all youth and to reduce disparities for future generations of immigrants in Europe.
Keywords
Health behaviours, cardiovascular risk, adolescent immigrants, bioecological model, BYAIMS
